I am not convinced that competition in the health market will effectively reduce costs. Health care poses other challenges and is driven by many factors that make it difficult to predict cost. For instance the largest health care costs may be in the last year of a life, but how is that predicted? How can we know that it is time to control costs by putting in place less costly options such as hospice or palliative care? Health care is not a product with predictable costs per unit. How do health care insurers and providers become competitive without risking either financial losses or undermining the quality of coverage and care. The goal should be to insure coverage that accounts for diverse factors that can maintain health and improve outcomes for the sick. It's complicated!